This project proposes to define the effects of organ preservation protocols involving high dose radiotherapy (5000+ cGy) with or without chemotherapy in 300 oral, laryngeal, and pharyngeal cancer patients with previously untreated Stages II to IV disease, and to measure the effectiveness of swallow maneuvers in improving the swallow. Each patient will be followed for 12 months after treatment completion. All patients will be studied pretreatment, and at 1 month, 3 months, 6 months and 12 months post completion of chemoradiotherapy. At each of these data collection points, each patient will receive a videofluoroscopic assessment of swallowing, a voice recording for acoustic analysis, and a speech analysis for understandability and articulatory production. Patients assessed at Northwestern University will receive manometry concurrent with videofluoroscopy. The radiographic studies of swallowing will be analyzed in detail for the physiologic swallowing disorders present, and the temporal and biomechanical characteristics of the swallow. Manometric studies will be analyzed for amplitude of pharyngeal contraction and hypopharyngeal bolus pressures. The voice recordings will undergo detailed acoustic analysis. The speech recordings will be examined for conversational understandability and percent correct articulation. Each patient's response to swallow maneuvers will be defined.